The fragmentation and separation of accountability for undergraduate medical education, junior doctor training, specialty training, and academic training between university and NHS partners results in a broken continuum of knowledge and experience for tomorrow's doctors.
Each of these alignment mechanisms has the potential to counter the separation of accountability for patient care, research, and education at the national level by improving accountability for the tripartite mission from the bottom up.
As more knowledge is generated, it should become possible to identify the mechanisms of greatest leverage for achieving enhanced accountability in different settings, and to see whether such mechanisms are strong enough to overcome the separation of accountability for the tripartite mission at the national level.
At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments.
At the heart of the challenge for AHSCs and AHSNs in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth, is the separation of accountabilities for the tripartite mission of patient care, research, and education in different government departments.
It remains to be seen which alignment mechanisms are most effective, and whether they are strong enough to counter the separation of accountabilities for the tripartite mission at the national level, the on-going structural fragmentation of the health system in England, and the unprecedented financial challenges that it faces.
It remains to be seen which alignment mechanisms are most effective and whether they are strong enough to counter the separation of accountabilities for the tripartite mission of academic medicine at the national level, and the unprecedented financial challenges that it faces.
The Palestinian Authority is being asked to do something that American administrations have not asked of any established Arab state: to create a true democracy, with civil protections, separation of powers, direct accountability of officials, freedom of the press and speech, and transparency of governing institutions.
There is no running water, no electricity, no health care, no separation of powers and no accountability by anyone to anyone.
Despite this change, there remains a separation of hierarchical and legal accountability between the NHS and universities, which makes it challenging for some academic and clinical partners to agree and conduct joint annual appraisal and performance review processes for staff working across organisational boundaries [ 36].
Turkey has recently been shaken by a massive corruption scandal that involves high government officials; freedom of expression, government accountability and even the separation of powers are increasingly under threat.
